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Northumbria University academics contribute to European Space Agency Topical Team that provided recommendations for future post-mission neuro-musculoskeletal reconditioning research and practice.

Between 2014 to 2016, Dr Nick Caplan, Dr Dorothee Debuse and Dr Andrew Winnard contributed to the European Space Agency Topical Team on "Post-mission Exercise (Rehabilitation)".  The Topical Team, which was chaired by Prof Maria Stokes (Southampton) was tasked with identifying operational and research priorities relating to the role of exercise and rehabilitation in astronauts, post-mission.  The Topical Team consisted of a strong team of international experts from the European Space Agency (Simon Evetts, Tobias Weber, Jonathan Scott, Gunda Lambrecht, Nora Petersen), Northumbria University (Nick Caplan, Dorothee Debuse, Andrew Winnard), DLR (Jochen Zange, Lieven Daneels, Joern Rittweger), the Australian Catholic University (Julie Hides) as well as ESA astronaut Andre Kuipers.  External advisors on the project included Dan Barry and Jacob Bloomberg (NASA), David Beard and Jonathan Cook (Oxford University), Filippo Castrucci (ESA), Dieter Blottner (Berlin Center of Space Medicine and Extreme Environments), Rebecca Cusack (Southampton University), Anna-Maria Liphardt and Anja Niehoff (German Sport University), Carly McKay (University of Bath), and Gita Ramdharry (Kingston University and St George’s University of London).

The aims of the Topical Team were:

  1. Identify acute and chronic neuro-musculoskeletal problems experienced by astronauts as a result of undertaking short and long-term space missions.
  2. Identify risk factors affecting successful reconditioning following spaceflight.
  3. Identify and document existing strategies for correcting deconditioning related to neuromusculoskeletal problems.
  4. Anticipate challenges to reconditioning likely to result from longer (exploration) missions.
  5. Document potentially useful reconditioning strategies to prevent and/or treat these long duration mission-derived challenges.
  6. Produce a report including recommendations for research prioritisation to enhance postflight reconditioning of ESA astronauts.

The Topical Team recommendations were:

  1. Effects of spaceflight on neuro-musculoskeletal function (Objective 1)
    1. More crew focused research is needed;
      1. on adaptation processes to improve inflight CM and postflight reconditioning strategies
      2. on the possible long-term effects of space travel (e.g. osteoporosis, osteoarthritis)
  2. 2Postflight effects (Obj 1) and risk factors impacting on reconditioning (Obj 2)
    1. Routine (anonymised) systems are required to capture data on musculoskeletal problems
    2. Use astronaut-specific personalised outcome measures
    3. Use novel technologies to assess muscle status inflight to help improve inflight CM to reduce postflight deficits.
  3. Improving existing reconditioning strategies after ISS missions (Obj 3)
    1. Multi-agency studies (quantitative and qualitative) are required for international consensus and guidance on reconditioning practice, and future research priorities
    2. Develop optimal reconditioning programmes - account for safe reloading; exercise dose, duration, rest periods, timing; functional activities of daily living; psychological factors.
    3. Obtain views of astronauts (using qualitative methods)
    4. Synthesise and build on existing evidence from relevant terrestrial populations in clinical specialties (e.g. back pain, neurology) and elite sports training
    5. Evaluate effectiveness of current and new post-ISS programmes.
    6. Minimise injury and ensure safe exercise for postflight reconditioning programmes
      1. Establish re-loading protocols that minimise tissue damage (e.g. joint cartilage, intervertebral discs, muscle injuries)
      2. Use movement screening tools to assess quality of movement pre- in-and postflight
      3. Develop tailored exercise programmes to re-educate movement control to protect joints from abnormal or excessive loading during exercise.
    7. Improve functional performance evaluation in postflight reconditioning
      1. Include functional tests relevant to activities of daily living.
    8. Improve motivation strategies for complying with and adhering to postflight reconditioning
      1. Investigate links between behaviours pre-flight, inflight, and postflight
      2. Utilise astronaut experiences to inform motivation enhancement strategies
      3. Understand the therapeutic alliance to enhance reconditioning outcomes
      4. Draw from motivation and adherence strategies in elite sports.
  4. Anticipating challenges to reconditioning from longer (exploration) missions (Obj 4) and developing reconditioning and preconditioning strategies in preparation for planetary surface explorations (Obj 5)
    1. Develop inflight exercise CM that are less time-consuming, functional, enjoyable and target multiple physiological systems simultaneously
    2. Establish inflight monitoring procedures to inform preconditioning programmes and determine readiness for safe and effective planetary surface excursions.
    3. Develop equipment/hardware for inflight preconditioning programmes.
    4. Bed rest studies to develop inflight preconditioning exercise programmes
    5. Develop non-technology based preconditioning exercise programmes
    6. Develop technologies for inflight monitoring of e.g. orthostatic intolerance, sensorimotor function and functional performance using sensors with feedback to astronauts
    7. Develop non-technology based exercises as contingency for equipment failure
    8. Develop optimal postflight reconditioning exercise programmes
    9. Identify and prevent potential barriers to ongoing health behaviours for designing mission specifications and generating policies

The full report can be found here.